hyperparathyroidism Flashcards
What is hyperparathyroidism?
It is caused by excess circulating parathyroid hormone. This increases calcium absorption from the gut, mobilisation of calcium from bones, and reduces calcium excretion via kidneys. This results in increased serum calcium levels.
/What are the causes of primary hyperparathyroidism
1) Primary hyparathyroid is caused by a benign ademona (can be carcinoma or hyperplasia) OR ectopic PTH production
What are the causes of secondary hyperparathyroidism?
PTH are persistently and appropriately raised to maintian serum calcium levels in the face of a disorder that lowers calcium levels.
E.g.
-chronic renal failure
-Vitamin D deficiency
What is tertiary hyperparathyroidism?
Tertiary hyperparathyroidism is when there is continued secretion of excess PTH after prolonged secondary parahypothyroidism even though the original cause is now gone.
What are the symptoms of hyperparathyroidism?
symptoms are due to bone disease and fractures caused by reduced calcium in bones.
features of hypercalcaemia: Bones,stones, Groans, moans - bone pain -renal stones -peptic ulcer -psychiatric disease (depression and confusion)
What do the bloods show for primary hyperparathyroidism?
Bloods:
- serum calcium (raised)
- Alk phosphate (high)
- serum phosphate (low)
- raised serum PTH
- serum Cl- (raised)
What do the bloods show for secondary hyperparathyroidism?
If renal failure
- calcium is low or normal
- phosphate is normal or high
What does the Xray of a patient with hyperparathyroidism show?
Xray shows subperiosteal reabsorption (will be more in hands)
Xray also shows evidence of osteitis fibrosa cystica.
Skull has pepperpot appearance.
Why is a chest xray done in hyperparathyroidism?
CXR is done to look for a carcinoma producing PTH.
What is the treatment for hyperparathyroidism?
Surgery - parathyroidectomy
